Administrative remedies. The Grantee agrees that any dispute, controversy, or claim arising out of or relating to unallowable expenditures under this Contract, whether during or after its term, shall be submitted to an administrative review before the Department’s Board. To initiate the process, the Grantee shall submit a written notice, in accordance with terms set forth herein, to the Department’s Executive Director or designee and all members of the Department’s governing board. Said notice shall specifically request a Board review and state the nature of the dispute, controversy, or claim. The Grantee shall also provide a copy of the notice to all members of the Grantee’s governing board. A Board review under this provision shall be a condition precedent to the filing of a contested case proceeding under the Administrative Procedure Act, Texas Government Chapter 2001. If the parties are unable to resolve the matter through the Department’s administrative review process, either party may elect to resolve the dispute or claim as a contested case. Neither the administrative review process nor a proceeding under the Administrative Procedure Act shall be construed to adversely affect any party's right to a judicial review. Neither the execution nor the performance of this Contract by the Department shall be construed to be a waiver of sovereign immunity to suit.
Administrative remedies. (1) At its discretion, HHSC may impose one or more of the following remedies for each item of noncompliance and will determine the scope and severity of the remedy on a case-by- case basis:
(A) Assess liquidated damages up to $500 per month or portion of the month the MA Dual SNP fails to provide a complete copy of the MA Agreement and all amendments, modifications, or changes as required by Section 3.05, or, in the case of all other breaches of this Agreement, assess liquidated damages up to $100 per calendar day until the breach is cured to the satisfaction of HHSC;
(B) Conduct accelerated monitoring of the MA Dual SNP. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent;
(C) Require additional, more detailed data or reports to be submitted by the MA Dual SNP;
(D) Withhold or recoup payment to the MA Dual SNP; or
(E) Terminate the Agreement in accordance with Article VIII.
(2) For purposes of this Agreement, an item of noncompliance means a specific action of the MA Dual SNP that:
(A) Violates any provision of this Agreement;
(B) Represents a failure of MA Dual SNP to be reasonably responsive to a request by HHSC for information, assistance, or support relating to this Agreement within the timeframe specified by HHSC.
(3) HHSC will provide notice to the MA Dual SNP of its assessment of an administrative remedy, with the exception of accelerated monitoring, which may be unannounced.
Administrative remedies. At its discretion, HHSC may impose one or more of the following remedies for each item of material noncompliance and will determine the scope and severity of the remedy on a case-by-case basis:
Administrative remedies. (1) At its discretion, HHSC may impose one (1) or more of the following remedies for each item of material noncompliance and will determine the scope and severity of the remedy on a case-by-case basis:
(i) Assess liquidated damages in accordance with Attachment B-3, “Liquidated Damages Matrix;”
(ii) Conduct accelerated monitoring of the MCO. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent;
(iii) Require additional, more detailed, financial and/or programmatic reports to be submitted by MCO;
(iv) Require additional and/or more detailed financial and/or programmatic audits or other reviews of the MCO;
(v) Decline to renew or extend the Contract;
(vi) Appoint temporary management under the circumstances described in 42 C.F.R. §438.706;
(vii) Initiate disenrollment of a Member or Members;
(viii) Suspend enrollment of Members;
(ix) Withhold or recoup payment to MCO;
(x) Require forfeiture of all or part of the MCO’s bond; or
(xi) Terminate the Contract in accordance with Section 12.03, “Termination by HHSC.”
(2) For purposes of the Contract, an item of material noncompliance means a specific action of MCO that:
(i) Violates a material provision of the Contract;
(ii) Fails to meet an agreed measure of performance; or
(iii) Represents a failure of MCO to be reasonably responsive to a reasonable request of HHSC relating to the Scope of Work for information, assistance, or support within the timeframe specified by HHSC.
(3) HHSC will provide notice to MCO of the imposition of an administrative remedy in accordance with this Section, with the exception of accelerated monitoring, which may be unannounced. HHSC may require MCO to file a written response in accordance with this Section.
(4) The Parties agree that a State or Federal statute, rule, regulation, or Federal guideline will prevail over the provisions of this Section unless the statute, rule, regulation, or guidelines can be read together with this Section to give effect to both.
Administrative remedies. (1) At its discretion, HHSC may impose one or more of the following remedies for each item of noncompliance and will determine the scope and severity of the remedy on a case-by-case basis:
(A) Assess liquidated damages up to $500 per month or portion of the month the MA Health Plan fails to provide a complete copy of the MA Agreement and all amendments, modifications, or changes as required by Section 3.05, or, in the case of all other breaches of this Agreement, assess liquidated damages up to $100 per calendar day until the breach is cured to the satisfaction of HHSC;
(B) Conduct accelerated monitoring of the MA Health Plan. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent;
(C) Require additional, more detailed data or reports to be submitted by the MA Health Plan;
(D) Withhold or recoup payment to the MA Health Plan; or
(E) Terminate the Agreement in accordance with Article VIII.
(2) For purposes of this Agreement, an item of noncompliance means a specific action of the MA Health Plan that:
(A) Violates any provision of this Agreement;
(B) Represents a failure of MA Health Plan to be reasonably responsive to a request by HHSC for information, assistance, or support relating to this Agreement within the timeframe specified by HHSC.
(3) HHSC will provide notice to the MA Health Plan of its assessment of an administrative remedy, with the exception of accelerated monitoring, which may be unannounced.
Administrative remedies. (1) At its discretion, HHSC may impose one or more of the following remedies for each item of noncompliance and will determine the scope and severity of the remedy on a case-by-case basis:
(A) Assess liquidated damages in accordance with the terms of the Agreement if provided in the Agreement;
(B) Conduct accelerated monitoring of the CONTRACTOR. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent;
(C) Require additional, more detailed, financial or programmatic reports to be submitted by CONTRACTOR;
(D) Decline to renew or extend the Agreement;
(E) Withhold or recoup payment for the noncompliant Service or Deliverable; or
(F) Terminate the Agreement in accordance with Section 11.03.
(2) For purposes of the Agreement, an item of noncompliance means a specific action of CONTRACTOR that:
(A) Violates a provision of the Agreement;
(B) Fails to meet an agreed measure of performance; or
(C) Represents a failure of CONTRACTOR to be reasonably responsive to a reasonable request of HHSC relating to the Services and Deliverables for information, assistance, or support within the timeframe specified by HHSC.
(3) HHSC will provide notice to CONTRACTOR of the imposition of an administrative remedy in accordance with this Section, with the exception of accelerated monitoring, which may be unannounced. HHSC may require CONTRACTOR to file a written response as part of the Tailored Remedy approach.
(4) The Parties agree that a State or Federal statute, rule, regulation, or Federal guideline will prevail over the provisions of this Section unless the statute, rule, regulation, or guidelines can be read together with this Section to give effect to both.
Administrative remedies. (1) At its discretion, HHSC may impose one or more of the following remedies for each item of material noncompliance and will determine the scope and severity of the remedy on a case-by- case basis:
(A) Assess liquidated damages up to $500 per month or portion of the month the MA Health Plan fails to provide a complete copy of the MA Agreement and all amendments, modifications, or changes as required by Section 3.05;
(B) Conduct accelerated monitoring of the MA Health Plan. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent;
(C) Require additional, more detailed data or reports to be submitted by the MA Health Plan;
(D) Withhold or recoup payment to the MA Health Plan; or
(E) Terminate the Agreement in accordance with Section 7.03.
(2) For purposes of this Agreement, an item of material noncompliance means a specific action of the MA Health Plan that:
(A) Violates a material provision of this Agreement;
(B) Represents a failure of MA Health Plan to be reasonably responsive to a request by HHSC for information, assistance, or support relating to this Agreement within the timeframe specified by HHSC.
(3) HHSC will provide notice to the MA Health Plan of its assessment of an administrative remedy, with the exception of accelerated monitoring, which may be unannounced.
Administrative remedies. (1) At its sole and absolute discretion, DIR may impose one of the following reme- dies for each Deficiency and/or Material Breach, and will determine the scope and severity of the remedy on a case-by-case basis:
(A) Assess Credits in accordance with the terms of this CTSA;
(B) Conduct accelerated monitoring of Vendor including more frequent or more extensive monitoring by DIR or its agents;
(C) Require additional, more detailed, marketing and/or performance reports to be submitted by Vendor;
(D) Decline to extend this CTSA and/or approve any or all new TEX-AN NG Customer Service Agreements or renew of any or all TEX-AN NG Cus- tomer Service Agreements; and/or
(E) Terminate this CTSA in accordance with Section 11.03, provided, how- ever, that the right to terminate hereunder shall be limited to those in- stances where:
1) The Deficiency constitutes a Material Breach;
2) DIR gives Vendor written notice of such Material Breach and speci- fies a reasonable cure period; and
3) Vendor does not cure the Material Breach within the applicable cure period.
(2) DIR will provide notice to Vendor of the imposition of an administrative remedy in accordance with this Section 11.02, with the exception of accelerated moni- toring, which may be unannounced. DIR may require Vendor to file a written response in accordance with this Section 11.02.
Administrative remedies. The parties further agree that nothing in this Exhibit precludes any party from filing or participating in administrative proceedings before the California Unemployment Insurance Appeals Board, California Workers Compensation Appeals Board, California Labor Commissioner, California Division of Labor Standards Enforcement, the California Department of Fair Employment & Housing, or similar California or federal administrative agencies, to address alleged violations of law enforced by those agencies. If the Participant exercises such administrative remedies, the Company will not retaliate against the Participant for doing so. The Company, however, reserves the right to oppose any such administrative proceeding, including on the grounds that such agency(ies) lack jurisdiction over any dispute, because of the parties’ independent contractor relationship. Notwithstanding the foregoing, to the extent permitted by law, if the Participant or the Company seeks to appeal any such administrative award to a court of competent jurisdiction and/or for a trial de novo in such a court, the Participant and the Company agree that that such appeal or trial de novo is subject to the binding arbitration requirement described above in this Exhibit.
Administrative remedies. Any claim, complaint, or protest against the WBC, or any controversy, appeal, or dispute concerning the WBC or any WBC contest, ruling, order, or action, or arising under the WBC Constitution or these Rules and Regulations must first be presented to the WBC as a claim that may be resolved by administrative remedies. To be recognized and valid, any such claim, claim, complaint, or protest must be submitted to the WBC President in writing by the aggrieved party or his authorized representative within fifteen (15) calendar days after the claim first arose. Each such claim, complaint, or protest must also be accompanied by a non- refundable fee of $2,500.00 to cover the costs and expenses of the WBC relating to the processing of any such claim, complaint, or protest. The WBC may in its sole discretion grant a waiver of all or a portion of such fee, but no such waiver shall apply unless it is granted in writing by the WBC and received by the protesting party. Upon receiving a recognized claim, the President, in his discretion, may attempt to resolve the claim, or may refer the matter to either the WBC Grievance and Appeals Committee or its Board of Governors. The WBC may institute such policies and procedures as it may deem appropriate from time to time for the administration and processing of any recognized claim. In general, the WBC representative(s) addressing such a claim will first investigate the claim, seek such additional information as may be required, hold hearings (telephonic or in-person) if necessary, and then issue a decision to accept or reject the appeal in whole or in part. The President shall notify all interested parties in writing of the decision of the WBC. In the event that the complainant remains unsatisfied with the WBC’s decision following these administrative remedies, the complainant must then seek compulsory mediation under Rule 5.3 hereof. No party may invoke or seek remedies under Rule 5.3 or Rule 5.4 without first seeking, and providing the WBC the opportunity to provide, administrative relief under this Rule 5.2.
